Maternal Infections

Question 1

how is rubella transmitted?

Answer 1

direct contact

respiratory droplets

Question 2

how does rubella present?

Answer 2

fever
rash
lymphadenopathy
poly arthritis

Question 3

what can maternal rubella infection result in?

Answer 3

miscarriage
still birth
birth defects

Question 4

what birth defects can be caused by maternal rubella?

Answer 4

CRS

cataracts, cardiac abnormalities and deafness

Question 5

how should maternal rubella be managed?

Answer 5

not immune - consider TOP

supportive treatment otherwise

Question 6

what causes measles?

Answer 6

paramyxovirus

Question 7

how does measles present?

Answer 7

fever 
koplik spots 
runny nose 
red eyes 
rash

Question 8

what are koplik spots?

Answer 8

white spots seen inside the mouth in measles

Question 9

is measles teratogenic?

Answer 9

no

Question 10

what possible foetal complications can measles cause?

Answer 10

IUGR 
microcephaly 
miscarriage 
stillbirth 
preterm birth

Question 11

how is maternal measles managed?

Answer 11

supportive care

Question 12

what causes chickenpox?

Answer 12

varicella zoster

transmission = droplets

Question 13

how does chicken pox present?

Answer 13

fever
malaise
vesicular rash

Question 14

how is chicken pox managed?

Answer 14

VZIG <10 days post exposure

supportive

consider acyclovir if >20 weeks

Question 15

what is the outcome of chicken pox at 7-28 weeks gestation?

Answer 15

foetal varicella syndrome

Question 16

what is the outcome of chicken pox at 4 weeks before delivery?

Answer 16

neonatal chicken pox

Question 17

what causes congenital varicella syndrome?

Answer 17

transplacental varicella zoster infection in pregnancy

Question 18

how is congenital varicella syndrome investigated?

Answer 18

refer to foetal medicine specialist for a detailed USS and foetal MRI

Question 19

what are possible complications of congenital varicella syndrome?

Answer 19

hypoplasia of limbs
psychomotor retardation
IUGR
cataracts
microcephaly

Question 20

what can maternal infection with cytomegalovirus lead to?

Answer 20

miscarriage
stillbirth
IUGR
microcephaly

Question 21

what is the main non genetic cause of sensorineural deafness?

Answer 21

cytomegalovirus

Question 22

what is the risk of congenital cytomegalovirus infection after maternal infection?

Answer 22

1st trimester = 30%

3rd trimester = 47%

Question 23

how is maternal cytomegalovirus managed?

Answer 23

valacyclovir and hyperimmune globulin

Question 24

what does parvovirus cause?

Answer 24

slapped cheek syndrome aka fifth disease

Question 25

what is the risk of foetal parvovirus infection after maternal infection?

Answer 25

1/3

Question 26

what are possible serious complications of foetal parvovirus infection?

Answer 26

aplastic anaemia congenital heart failure hydrops foetal death

Question 27

when is risk of foetal loss higher due to parvovirus infection?

Answer 27

infection <10 weeks gestation

Question 28

how is parvovirus diagnosed?

Answer 28

detection of virus specific IgM

Question 28

how is parvovirus diagnosed

Question 29

what investigations should be done if maternal parvovirus is diagnsoed?

Answer 29

referral to a foetal medicine specialist for serial USS and foetal MCA doppler

Question 30

describe the effects mumps infection has on pregnancy

Answer 30

none | not teratogenic

Question 31

can the MMR live vaccine be given in pregnancy?

Answer 31

no

Question 32

what are possible effects of a virulent influenza infection in pregnancy?

Answer 32

miscarriage preterm labour however usually no effect

Question 33

can the influenza vaccine be given in pregnancy?

Answer 33

yes alss safe in breast feeding

Question 34

what causes primary infection with Zika virus?

Answer 34

a mosquito bite

Question 35

what serious birth defects can be caused by Zika virus?

Answer 35

``` microcephaly brain defects problems with hearing and vision seizures developmental delay ```

Question 36

what causes genital herpes infection?

Answer 36

HSV2 sexually transmitted

Question 37

what type of herpes carries a high risk of foetal infection?

Answer 37

primary genital HSV

Question 38

what can increase the risk of vertical transmission of HIV?

Answer 38

preterm birth | PROM

Question 39

what drug should be given prior to CS in HIV positive patients?

Answer 39

zidovudine four hours prior

Question 40

what causes toxoplasmosis?

Answer 40

toxoplasmosis gondii found in raw meat and cat poo

Question 41

what congenital effects can toxoplasmosis have?

Answer 41

``` hydrocephalus chorioretinitis cerebral calcifications microcephaly mental retardation ```

Question 42

what causes listeriosis?

Answer 42

listeria monocytogenes

Question 43

is listeriosis more or less common in pregnant women compared to the rest of the population?

Answer 43

ten times more common in pregnant women

Question 44

what are the possible obstetric complications of listeriosis?

Answer 44

late miscarriage preterm labour stillbirth

Question 45

how does listeriosis present?

Answer 45

flu like or food poisoning like symptoms

Question 46

how is listeriosis managed?

Answer 46

ampicillin + gentamicin OR trimethoprim + sulfamethoxazole